Lecture 3 Flashcards
Should patient’s in the acute phase have bed rest?
What should we encourage?
What treatments are most beneficial if used early
No, if possible, if severe atleast less than 2 days
Early motion, WALKING
manual therapy is most benefcial used early in patients without radiating pain
What are the goals of the acute phase
Decreased pain, inflammation, spasm
Promote tissue healing
increase pain free ROM
regain soft tissue extensibility
regain NM control
What are the goals of the subacute phase
Acheive significcant decrease in symptoms of acute resolution of pain
restore full pain free ROM
full integration of upper and lower kinetic chains
restoration of respiratory function
Research suggests that the _______ phase is critical in preventing chronicity and disability
subacute
What is chronic pain
Pain in the absence of tissue damage
What is primary hyperalgesia
secondary hyperalgesia
primary- normal pain due to tissue damage
secondary- adaptation in CNS, increased responsiveness to stimuli from periphery
What is central sensitization
functional changes in CNS due to chronic pain
altered sensory processing
malfunctioning of descending anti-nociceptive mechanisms
increased activity of pain pathways
The Chicago roll/ million dollar roll mainly works on what part of the spine?
Where do you apply pressure down?
SI joint
ASIS
T or F: Direction-specific exercises/mckenzie exercises are tissue specific
F
How often should a patients preform their extension direction specific exercises
20 times per hour while awake
If a patient has lateral shift, can they still do extension/flexion repeated motions
No the lateral shift must be corrected first
How often should patients preform their flexion repeated motion exercise
6-10 times per hour they’re awake
How many reps of nerve glides should a patient do
1 set of 10-15 reps in initial session to avoid irritating nervous tissue
T of F: majority of evidence supports passive modalities for back pain
F
What is the proposed progression for treatment sessions
- Manual techniques
- Mobility exercises
- Neuromuscular education
- Strength training
- Functional/therapeutic activity tolerance
T or F: when educating LBP patients you should emphasis anatomy
F
T or F: Patients with LBP should return to normal activities asap
T
You should use _____ manipulation techniques for acute LBP
You should use thrust and nonthrust techniques for subacute and chronic LBP
Thrust
Joint manipulation contraindications
Presence of serious pathology
PT skill/experience
Fracture
Ligament rupture
No working hypothesis
Worsening neurological function
Unremitting night pain
Severe multidirectional spasm
UMN lesions
Is there clear evidence that Dry needling helps patients with LBP
No
May consider this for subacute
Not effective than any other modality for acute
When is surgical intervention warranted
Cauda equina
B&B disturbances
Onset or progression of significant motor deficit
Significant instability (spondy 4 or 5)
Progression of spinal deformities (curve over 45)
Symptoms do not improve in X amount of time
What is the most common diagnosis that results in a lateral shift
Herniated Disc
How do you differentiate between opening a closing issues?
Problem w/ spinal flexion - opening issue
Problem w/ spinal extension - closing issue
Then from here you can figure out which side opening or closing
